Q: I’m experiencing erectile dysfunction. What does this mean for my health?

A: Erectile dysfunction (ED) is the consistent inability to achieve or maintain an erection sufficient for sexual activity. It affects nearly 30 million men in the United States.

Men should know ED often develops as a consequence of other medical conditions. Erections require blood flow to the penis, so ED often results from conditions that restrict blood flow or damage nerves and arteries. Common causes of ED include:

  • Heart disease. Plaque from high cholesterol levels can narrow and clog arteries leading to the penis, reducing blood flow. Smaller arteries — such as the ones needed for erectile function — tend to be affected first. Many men are unaware of this early sign of cardiovascular disease.
  • Diabetes. Poor long-term blood sugar control can damage nerves and blood vessels and cause ED. About 53% of men with diabetes experience ED, according to Diabetic Medicine.
  • Low testosterone. Low levels of the male hormone testosterone can cause reduced erection potential. Being treated for low testosterone can reverse this cause of ED.

Most cases of ED have physical causes, but psychological factors can be the reason for some men. Performance anxiety, depression, low self-esteem, and traumatic experiences can lead to ED, or even worsen existing ED caused by medical conditions. For example, diabetes-induced moderate ED could lower a man’s self-esteem or increase anxiety, potentially causing severe ED.

While old age itself is not a cause of ED, prevalence of ED increases with age as cardiovascular disease, diabetes and low testosterone become more common. Older men experiencing ED likely have another health condition interfering with erectile function that may require medical attention.

But ED can happen at any time in a man’s life. ED with no obvious cause should prompt men to talk to their doctor and have a complete evaluation.

Common ED medications are generally safe to use with other medications, with one exception. Men with known cardiovascular disease who take nitrates, medications that widen blood vessels, cannot take ED drugs because the combination can cause a dangerous drop in blood pressure.

Men can take proactive measures to limit their risk of developing medical conditions that cause ED, such as:

  • Healthy diet. Limit overindulgences (such as alcohol, sweets, and fatty foods) and enjoy everything in moderation to keep cholesterol levels low.
  • Exercise regularly. Physical activity will help maintain a healthy body weight, limiting the risk of obesity and cardiovascular disease.
  • Learn your family history. Talk to relatives to know what medical conditions tend to run in the family.
  • See a physician regularly. Men over 40 should see a doctor annually to monitor for common health problems as they age.

Men should feel comfortable talking with their physicians about ED, and physicians should help their patients feel comfortable by addressing ED in a one-on-one setting. See your primary physician as soon as you experience ED.

Noah May is a urologist at Mercy Catholic Medical Center.